Three-dimensional distribution of neuromuscular junctions in human cricothyroid

Microinjections of myoneural blocking agents are effective in the treatment of strabismus and have been proposed as a possible technique to treat spastic dysphonia. The success of such a technique would rely on a precise knowledge of the neuromuscular junction distribution in the laryngeal muscle to be injected. In view of the possibility of an involvement of the cricothyroid muscle in spastic dysphonia or other neuromuscular disorders, we determined the three-dimensional distribution of neuromuscular junctions in the human cricothyroid muscle. Cricothyroid muscles obtained from autopsy cases were fixed, sectioned, and processed for the histochemical localization of neuromuscular junction acetylcholinesterase. Using serial sections and a computer interfaced X-Y digitizer, the neuromuscular junctions were referenced to various anatomic landmarks and the neuromuscular junction distribution and reconstructed in three dimension using computer graphics.